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Individual

MRS. LAURA MARIE HOTLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
1465 S GRAND BLVD, 01 OFFICE ROOM #2730, SAINT LOUIS, MO 63104-1003
(314) 577-5647
(314) 268-2775
Mailing address
1465 S GRAND BLVD, 01 OFFICE ROOM #2730, SAINT LOUIS, MO 63104-1003
(314) 268-2700
(314) 268-2775

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
019009
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
2001019009
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
427362207
MO
Enumeration date
12/09/2005
Last updated
01/18/2021
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